Compliance News Week Ending March 28, 2025

In this Article

Reminder - RxDC Reporting

Annual RxDC reporting is required by June 1 of each year.

Reporting for the data from 2024 will be due June 1, 2025.

The reporting consists of a plan file (P2), eight data files (D1 – D8) and accompanying narratives. Most employer-sponsored health plans rely heavily on their carriers, TPAs, and PBMs to provide the data necessary, and in many cases, to submit the reporting to CMS on behalf of employer group health plans.

To complete the reporting, the carrier or TPA may reach out to employers to ask for information about premium splits (employer and employee contributions) as well as other data required for the D1 file.

Once this information is provided, the carrier, TPA and/or PBM may handle the entirety of a group health plan’s RxDC reporting, so employers should make sure to timely respond to such requests. If the employer fails to timely respond with the requested data, or if the carrier/TPA is unwilling to help with the D1 file, the employer may have to submit a P2 and D1 file on their own.

Click on the link below to find out if the carriers are requiring information from the employers.

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